HORIZON Nxt®

Operation Manual

©1999 B.Braun Medical Inc.

This manual may not, in whole or in part, be copied, photocopied, reproduced, translated, or converted to any electronic or
machine-readable form without prior written consent of B.Braun Medical Inc.

950520 Rev F
Table of Contents
Chapter 1 INTRODUCTION.....................................................................................1-1
Warranty ..............................................................................................................1-1
Intended Use .......................................................................................................1-2
Epidural Administration ............................................................................... 1-2
Blood Infusion .............................................................................................. 1-3
q(x)o ............................................................................................................. 1-3

Chapter 2 PRODUCT DESCRIPTION .....................................................................2-1

Operating Modes..................................................................................................2-1
Operating States ...................................................................................................2-1
Illustrations ..........................................................................................................2-2
Important Keys ....................................................................................................2-4
Daisy Chaining ....................................................................................................2-4
Battery Operation.................................................................................................2-4

Chapter 3 PRINCIPLES OF OPERATION...............................................................3-1

Cassette Removal.................................................................................................3-1
Standard Mode .....................................................................................................3-2
For Primary Fluids ....................................................................................... 3-2
For Piggyback Fluids ................................................................................... 3-2
Piggyback Callback .............................................................................................3-3
Changing the Rate................................................................................................3-3
During Infusion (titration) ........................................................................... 3-3
With Pump on Hold ..................................................................................... 3-4

Chapter 4 MENUS ....................................................................................................4-1

Main Menu ..........................................................................................................4-1
Alternate Menu ....................................................................................................4-1
Change Alarm Volume ................................................................................ 4-2
Clear Total Infused ...................................................................................... 4-2
Dose Mode .................................................................................................... 4-2
Occlusion Limit ........................................................................................... 4-3
Alternate Menu Items .........................................................................................4-4
Calculate BSA .............................................................................................. 4-4
Set LCD Contrast.......................................................................................... 4-4

Chapter 5 CUSTOM MENU OPTIONS ..................................................................5-1

Check Battery Level ...........................................................................................5-2
Hold Extender ......................................................................................................5-3
Micro Rate / Limit ...............................................................................................5-3
Monitor Docking..................................................................................................5-4
Occlusion Warning ..............................................................................................5-1
Piggyback Callback .............................................................................................5-5
PROFILE Mode ..................................................................................................5-5
PROGRAM Mode ..............................................................................................5-5
q (x)° Schedule.....................................................................................................5-5
Schedule Next Run .............................................................................................5-9
Select MAX Pressure ..........................................................................................5-10
Set PROFILE Parameters ...................................................................................5-11
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950520 Rev F
 Set Time and Volume .........................................................................................5-11
Site Trend.............................................................................................................5-12
Exit from Menu....................................................................................................5-12

Chapter 6 DOSE MODE ...........................................................................................6-1

Drug Menus .........................................................................................................6-1
Epidural Category ................................................................................................6-2
Concentration Screen ...........................................................................................6-2
Data Screen ..........................................................................................................6-2
Change SetUp Parameters ..................................................................................6-3
Titrate Rate .........................................................................................................6-4
Titrate Dose .........................................................................................................6-4
Exit DOSE Mode ................................................................................................6-4

Chapter 7 SPECIAL MODES....................................................................................7-1

Profile Mode ........................................................................................................7-1
Change Profile Parameters: ...........................................................................7-1
Data Entry .....................................................................................................7-1
Review/Change PROFILE Data ....................................................................7-2
Restart PROFILE ...........................................................................................7-2
Immediate Ramp Down ................................................................................7-2
Exit PROFILE Mode ....................................................................................7-3
Program Mode ....................................................................................................7-4
Data Entry .....................................................................................................7-4
Review/Change PROGRAM ........................................................................7-5
Restart PROGRAM .......................................................................................7-6
Skip PROGRAM Periods .............................................................................7-6
Exit PROGRAM Mode .................................................................................7-6

Chapter 8 MAINTENANCE ....................................................................................8-1

Cleaning ..............................................................................................................8-1
Alarm Procedures ................................................................................................8-2
Alarm Troubleshooting Guide .............................................................................8-3
Cautions ..............................................................................................................8-5
Service and Performance Information .................................................................8-7
Specifications ......................................................................................................8-8

Chapter 9 Table 1 DRUG LIST ................................................................................9-1

Index ....................................................................................................................Index-1

Horizon Nxt® 6/00

Modular Infusion System
950520 Rev F
Chapter 1 INTRODUCTION
Warranty
B. Braun Medical Inc., hereby warrants that reasonable care has been used
in the manufacture of each Horizon Nxt® and that it shall be free from
defects in material and workmanship for a period of two years after the date
of shipment, when properly used and maintained. Any Horizon Nxt® that
is found not to meet these standards within this two-year period will be
repaired after examination by B. Braun Medical or, at B. Braun Medical’s
option, will be replaced without charge. If the defect has been caused by
misuse, unauthorized modification, or abnormal conditions or operation,
repairs will be billed at B. Braun Medical’s then current charges. In this
case, an estimate will be submitted before work is started, if requested. The
defective device should be returned promptly to B. Braun Medical, properly
packaged, postage prepaid. Loss or damage in return shipment to B. Braun
Medical will be at purchaser’s risk. The foregoing express warranty, as
conditioned and limited, is in lieu of and excludes all other warranties not
expressly set forth herein, whether expressed or implied by operation of law
or otherwise including, but not limited to, any implied warranties of
merchantability or fitness, since handling, storage, and cleaning of these
devices, as well as factors relating to other matters beyond B. Braun
Medical’s control, directly affect these devices and the results obtained from
their use. B. Braun Medical shall not be liable for any incidental or
consequential loss, damage, or expense, directly or indirectly arising from
the use of this device other than replacement of all or part of it. B. Braun
Medical neither assumes, nor authorizes any other person to assume for it,
another or additional liability or responsibility in connection with this
device.

This warranty will not apply to any Horizon Nxt® or component thereof
which has been: (1) repaired by anyone other than an authorized B. Braun
Medical trained technician or repair facility; (2) altered in any way that, in
B. Braun Medical’s judgement, affects its stability or reliability; (3)
subjected to misuse, negligent handling, or accident; (4) used in any manner
not in accordance with the instructions furnished by B. Braun Medical in the
Operation and/or Service Manual.

This warranty extends only to the first purchaser or lessee and does not
extend to, and may not be enforced by, any other person.

Horizon Nxt®
Modular Infusion System 1-1 6/00
950520 Rev F
Intended Use

The Horizon Nxt® is intended for use with B. Braun Medical Horizon®
I.V. sets to regulate the flow of primary and secondary fluids when positive
pressure is required. The infusion system is capable of delivering fluid from
a negative head height (when the I.V. fluid container is lower than the
pump), and provides clinically accepted volumetric accuracy for all
standard I.V. fluids, including blood, lipids and TPN.

Positive pressure is frequently a necessity but clinical experience shows that

high pressure limits can increase the severity of an infiltration without
causing an alarm. Because there is a need to control pump pressure settings,
the Horizon Nxt has user-selectable occlusion pressure limit settings which
start at 75 mmHg and extend to 500 mmHg. At rates of 400 mL/hr and
higher, the pressure setting is automatically increased to 400 mmHg. For
epidural infusions which require higher pressures, the pump has an extended
occlusion pressure setting of 750 mmHg.

Because some infusions require multiple flow rates during the delivery
cycle, the Horizon Nxt is equipped with two automatic multiple delivery
rate modes. The Profile Delivery mode incorporates a standard ramped
delivery regimen, and the Programmable Delivery mode can be set up to
sequentially deliver up to nine user-selected volumes of fluid each at a user-
selected rate. Both modes are designed for ease of and can be adapted to
home-care settings.

The Horizon Nxt also incorporates a Dose/Rate mode which automatically

calculates the rate when dose information is entered, or the dose when rate
information is entered.

The pump is equipped with distinct audible and visual alarm signals to
indicate KVO, low battery, and actual alarm conditions.

Epidural Administration

The Horizon Nxt can be used for epidural administration of anesthetic and
analgesic drugs.

Caution: Whenever the pump is being used for epidural infusions, the
pump’s secondary infusion features should not be used.

For epidural administration of anesthetic drugs, use indwelling catheters

specifically indicated for short-term (96 hours or less) anesthetic epidural
drug delivery.

Horizon Nxt®
Modular Infusion System 1-2 6/00
950520 Rev F
 For epidural administration of analgesic drugs, use indwelling catheters
specifically indicated for either short-term or long-term analgesic epidural
drug delivery.

When the Horizon Nxt® is being used for epidural infusions, the source
container and administration set should be clearly differentiated from source
containers and administration sets used for other routes of infusion.

Caution: To prevent inadvertent infusion of drugs which are not indicated

for epidural use, only Horizon microbore administration sets,
without injection sites, that are specified for epidural
administration of drugs should be used.

Following an occlusion alarm, a small amount of fluid may be delivered.

Use of a microbore set assures this is less than 0.1 mL.

The administration of drugs is restricted to those anesthetic and analgesic

drugs labeled for continuous epidural administration.

Warning: Serious injury to the patient may result from epidural

administration of drugs other than those specifically labeled for
epidural use.

Blood Infusion

The Horizon Nxt can be used for infusion of blood and blood products. For
blood infusion, a Horizon Pump Blood Set should be used. Do not attempt
to piggyback blood. The normal saline roller clamp on the blood tubing set
must be clamped off. The high viscosity of blood will cause the saline to
infuse before the blood if both clamps are left open.

q(x)°

The Horizon Nxt can be used for the periodic infusion of antibiotics,
chemotherapy or other IV infusions according to a schedule set by the user.
Assure that there is a maintenance IV infusing in the intervals between
pump infusions.

Horizon Nxt®
Modular Infusion System 1-3 6/00
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Chapter 2 PRODUCT DESCRIPTION

The Horizon Nxt® has been developed in reponse to the special needs of all
caregivers in the medical setting.

Operating Modes

The Horizon Nxt pump has five operating modes:

Standard Mode - for simple IV fluid delivery with piggyback capability.

Dose Mode - used for administration of medication where concentrations

and doses are critical. The pump will automatically calculate either the dose
or rate.

Profile Mode - offers a tapered delivery mode for infusing TPN or other
fluids requiring ramp up and ramp down time.

Program Mode - offers maximum flexibility in customizing IV fluid

administration. Up to 9 separate periods of fluid volume can be infused
sequentially.

q(x)° Mode - can be used for the periodic infusion of antibiotics,

chemotherapy or other IV infusions according to a schedule set by the user.
Assure that there is a maintenance IV infusing in the intervals between
pump infusions.

Operating States

There are 4 operating states:

Hold - silences an alarm, stops an infusion, or is a quick escape from the

menu.

Alarm - stops an infusion to notify the user of an error.

KVO - 3 mL/hr for delivery rates of 3 to 999.9 mL/hr, or the continuation

of the delivery rate for 0.1 to 2.9 mL/hr settings.

Run - starts the infusion.

Horizon Nxt®
Modular Infusion System 2-1 6/00
950520 Rev F
 Illustrations:

Figure 1: Front View

1. Alarm Indicator 12. Hold Key

2. Run Indicator 13. Menu Key
3. Hold Indicator 14. Cursor Keys
4. Battery Use Indicator 15. Enter Key
5. AC Use Indicator 16. Piggyback Rate Display
6. Power Key 17. Piggyback Volume Display
7. Primary Indicator Key 18. Information Screen
8. Piggyback Indicator Key 19. Primary Rate Display
9. Primary Run Key 20. Primary Volume Display
10. Piggyback Run Key 21. Door Lever
11. Data Keys

7 6 5 4 3 2 1 9 10

21

19
19 20
20
18
18
16
16 17
17

8 12
11 13 14 15

Horizon Nxt®
Modular Infusion System 2- 2 6/00
950520 Rev F
 Figure 2: Rear View

1. Panel Lock Out Switch

2. Serial Communication Data Port

1 2

B. Braun Medical
Carrollton, TX 75006

Figure 3: Inside the Door

1 2 3

1. Cassette Alignment Pins

2. Air-In-Line Detector
3. Free Flow Protection Clip

Horizon Nxt®
Modular Infusion System 2-3 6/00
950520 Rev F
Important Keys

An understanding of the function and location of these keys will assist in the
use of the pump.

From Figure 1:

• Power key (6) turns the pump on and off

• Data keys (11) allow input of data values
• Hold key (12) silences an alarm, stops an infusion, is a quick escape from
the menu, and extends the Hold state an additional 3 minutes every time it
is pushed if Hold Extender is active.
• Menu Key (13) lets the user see options using a menu screen
• Cursor keys (14) move the cursor bar on the Information Screen
• Enter key (15) validates or accepts the selection made

From Figure 2:

• Panel Lock Out Switch locks the keypanel to prevent tampering. The
switch can only be used while the pump is infusing.

Daisy Chaining

Daisy chaining allows up to 5 Horizon Nxt® or Horizon® pumps to be

plugged into each other with only one pump plugged into a wall outlet. On
the side of each Horizon Nxt pump is an electrical outlet. Only another
Horizon or Horizon Nxt pump should be plugged into that outlet.

Caution: To daisy chain more than 5 pumps, verify that the total leakage
current as a system does not exceed 100 uA.

Battery Operation

The Horizon Nxt has been equipped with an internal, rechargeable battery
which will power the pump automatically if the plug is disconnected during
use. Battery power is provided as a back-up system only, and the length of
the battery life is affected by the rate of delivery. Whenever possible, the
pump should remain plugged into an electrical outlet. The Battery Use
indicator will be lit when the pump is operating on its battery.

The pump must remain plugged into a hospital-grade electrical outlet for at
least 24 hours to fully recharge the battery from a totally discharged
condition.

Horizon Nxt®
Modular Infusion System 2- 4 6/00
950520 Rev F
Chapter 3 PRINCIPLES OF OPERATION
Caution: Use only with B. Braun Medical Horizon® I.V. Sets

1) To attach the pump to the I.V. pole:

a) Press down on the pole clamp lever.

b) Position the pump on the pole (make sure the pole is up against
the slot of the pump).
c) Release the pole clamp.
d) Lock by rotating the pole clamp lever 1/4 turn, toward the rear
of the pump.

2) Plug the pump’s power cord into a hospital-grade electrical outlet, or the
AC Receptacle on the side of another Horizon or Horizon Nxt pump.
3) Press the Power key. If the Information Screen says:

"PROGRAM Operation Was Interrupted..." choose an option using the

CURSOR keys. Press the ENTER key.
"PROFILE Operation Was Interrupted..." choose an option using the
CURSOR keys. Press the ENTER key.

4) Open the door of the pump by pulling the Door Lever.

5) Prepare the IV fluids as described on the set package. Close the
downstream roller clamp.
6) Position the cassette over the Cassette Alignment Pins, with the metal
disc toward the pump. Thread the tubing through the Air-In-Line
Detector. Insert and press the Free Flow Protector Clip into the
receptacle.

Warning: Unrestricted fluid flow may occur if the Free Flow Protector
Clip is not properly installed in the receptacle.

7) Close the door of the pump.

8) Open all clamps on the pump set.

Note: Do not use a pump with visible damage or with bent, damaged or
missing components.

Cassette Removal

1) Press the HOLD key. Open the door of the pump.

2) Grasp the Free Flow Protector Clip and pull it from the Free Flow
Protector receptacle while grasping the tubing as it enters the left side of
the pump. Gently pull with both hands to remove the cassette from the
pump. Grasping the Free Flow Protector Clip and removing it from the
pump will automatically stop the flow of fluid in the tubing.
3) If gravity infusion is desired, close the roller clamp, open the Free Flow
Protector Clip and adjust the flow with the roller clamp.

Horizon Nxt®
Modular Infusion System 3-1 6/00
950520 Rev F
Standard Mode

For Primary Fluids:

1) Press the PRIMARY INDICATOR key.

2) Press the DATA keys to enter the rate and volume.
3) Press the PRIMARY RUN key to start the infusion.
4) Press the PANEL LOCK OUT SWITCH to make the key panel tamper proof, if
desired.

The time left, total infused, and occlusion pressure limit are shown on the
Information Screen. Monitor the infusion according to hospital policy.
After the infusion is complete, the pump will alarm and go into the KVO
state.

For Piggyback Fluids:

The Piggyback option can only be enabled by Biomedical personnel. The

piggyback option is not available while operating the pump in the Dose
Mode.

Caution: Do not attempt to infuse both fluids simultaneously using this

method.

1) Prepare IV fluids according to the set package. Use primary sets with
check valves.
2) Connect the piggyback set to the upper injection site (the site above the
pump) on the primary set.
3) Lower the primary bag at least 8 inches.

Note: To minimize or prevent fluid flow from the primary container during
Horizon Nxt®
ModularInfusion System 3-2 6/00
950520 Rev F
 a piggyback infusion (sympathetic flow), it may be necessary to
lower the primary bag more than 8 inches or clamp off the primary
tubing. Sympathetic flow increases significantly when the
piggyback rate is greater than 125 ml/hr, and clamping the primary
tubing is recommended at rates greater than 125 ml/hr.

4) Press the PIGGYBACK INDICATOR key.

5) Enter the Piggyback rate and volume.

Note: The programmed Piggyback volume to be infused must be equal to

the amount of fluid in the Piggyback container to prevent incorrect
delivery. Automatic piggyback is not intended for the infusion of
fluids requiring flushing before and after administration because of
incompatibility.

6) Press the PIGGYBACK RUN key.

When the Piggyback volume is complete, the Piggyback Rate and Volume
Displays will blank. The Primary Rate and Volume Displays will light up.
The infusion will now be delivered at the primary rate. Make sure the
primary tubing is not clamped.

Note: If the secondary container is not empty, the remaining secondary

fluid will be delivered at the primary flow rate.

Piggyback Callback

This feature causes the pump to alarm and continue the infusion at a KVO
rate after the programmed piggyback volume is infused. Piggyback
Callback must be selected in the User menu.

Changing the Rate

During Infusion (titration):

1) Press the DATA keys to change the rate.

2) Press the ENTER key or the PRIMARY RUN key to validate data.

Note: If the ENTER key or RUN key is not pressed within 4 seconds of
entering a new rate, a series of error beeps will occur and the rate
change will be cancelled. The pump will then display the message
"Rate change aborted", and will continue to infuse at the old rate.
An intermittent alarm will continue to sound to notify the user that a
rate change has been attempted and cancelled. Pressing any key will
silence the alarm.
With Pump on Hold:

Horizon Nxt®
Modular Infusion System 3-3 6/00
950520 Rev F
 1) Press the HOLD key.
2) Press the DATA keys to change the rate.
3) Press the RUN key to start the infusion.

Horizon Nxt®
ModularInfusion System 3-4 6/00
950520 Rev F
Chapter 4 MENUS

The Horizon Nxt® can be customized to fit your specific needs. The User
Menu and Alternate Menu contain options identified by each individual
hospital. The following options will always appear in one of the 2 menus.

Main Menu

Change Alarm Volume changes the volume of the audible alarm.

Clear Total Infused clears the total IV fluid infused shown on the
Information Screen.
Dose Mode calculates the rate or dose information necessary for use with
many critical drug infusions.
Occlusion Limit sets the occlusion pressure limit to 75, 100, 200, 300, 400
or 500 mmHg.
Alternate Menu lists options used less often by the user.
Exit from Menu returns to the Information Screen.

Alternate Menu
Calculate BSA calculates the body surface area (BSA).
Set LCD Contrast changes the readability of the Information Screen.
Biomed Options allows access to the Biomed Menu.
Exit from Menu returns to the Information Screen.

Horizon Nxt®
Modular Infusion system 4-1 6/00
950520 Rev F
 Change Alarm Volume:

The volume of the alarm can be changed to low, medium or high.

1) Press MENU key

2) Press CURSOR keys to select Change Alarm Volume
3) Press ENTER key

1) Press CURSOR keys to change the Change Alarm Volume

intensity of the alarm
2) Press ENTER key Low
Medium
High
Move Cursor & Press ENTER

The pump will return to the previous Hold or Run state.

Clear Total Infused

This feature clears the Total Volume displayed on the Information Screen.

Note: The volume can be cleared while the pump is running.

1) Press MENU key

2) Clear Total Infused is already selected
3) Press ENTER key.

1) Press ENTER key. The present Total Infused

2) The total volume displayed of 125.02 ml will be
on the Information Screen zeroed. Is this OK?
goes to zero.
Yes No
Cursor & Press ENTER

The pump will return to the previous Hold or Run state.

Dose Mode:
The Dose Mode is fully described in the Dose Mode Chapter.

Horizon Nxt®
Modular Infusion System 4 -2 6/00
950520 Rev F
 Occlusion Limit

This feature lets the user change the occlusion pressure limit to 75, 100, 200,
300, 400, or 500 mmHg. At rates of 400 mL/hr and higher, the pressure
setting is automatically increased to 400 mmHg. Occlusion pressure is a
threshold value.

For Example: If the occlusion pressure is set to 300 mmHg, the pump will
infuse at the lowest pressure possible but will alarm if the
pressure required to infuse the IV fluid rises above the 300
mmHg value.

A gravity infusion of D5W with the IV container 3 feet above the IV site is
equivalent to approximately 70 mmHg.

The occlusion warning feature is optional. The occlusion warning feature

gives an audible warning (3 beeps) and a visual indication in the LED
display to let the user know an occlusion is occuring downstream from the
pump. This warning occurs 5 times at 5-second intervals before alarming
“Occlusion.” This feature is designed to alert the clinician of downstream
resistance before an alarm occurs which stops the infusion.

Caution: The higher the pressure limit, the less sensitive the pump is to
changes in fluid resistance which may be caused by positional
IV’s or infiltrations. High pressure limits can increase the
severity of an infiltration without an alarm condition.

Note: To select a pressure of 750 mmHg, refer to Select MAX

Pressure.

1) Press MENU key

2) Press CURSOR keys to select Occlusion Limit
3) Press ENTER key
4) Press DATA keys to change the pressure limit
5) Press ENTER key

The pump will return to the previous Hold state.

Horizon Nxt®
Modular Infusion system 4-3 6/00
950520 Rev F
Alternate Menu Items:

Calculate BSA:

Use this feature to calculate body surface area (BSA).

1) Press MENU key

2) Press CURSOR keys to select Calculate BSA
3) Press ENTER key

Note: Height can be measured in centimeters (cm) or inches (in). Weight

can be measured in grams (g), kilograms (kg) or pounds (lb). The
height and weight parameters are changed by pressing theCursor to
select the parameter and pressing the up or down Cursor key.

1) Press CURSOR keys to select “Ht” and Calculate BSA

“Wt” values Ht = 100 cm Wt = 70 kg
2) Press the DATA keys to enter
the information BSA = 1.23 m2
3) The BSA value is displayed
4) Press ENTER to exit Press ENTER when done

Set LCD Contrast:

This option allows the user to change the readability of the Information
Screen.

1) Press MENU key

2) Press CURSOR keys to select Set LCD Contrast
3) Press ENTER key

1) Press right and left CURSOR keys EXIT

to vary the contrast
2) Press ENTER key to validate Adjust cursor until
this message is clear.
Then press ENTER key.

The pump will return to the previous Hold or Run state.

Horizon Nxt®
Modular Infusion System 4 -4 6/00
950520 Rev F
Chapter 5 CUSTOM MENU OPTIONS

The following items can be added to either the User or Alternate

Menus by the Biomedical Department. The Custom Menu items are
listed in alphabetical order.

Check Battery Level graphically displays the state of the charge of

the battery.
Hold Extender lengthens the hold time to a maximum of 120
minutes. This option must be turned on by the Biomedical
Department.
Micro Rate / Limit limits the infusion rate. (Useful for Pediatric and
Neonatal settings).
Monitor Docking allows the Horizon Nxt® with MedScan to
communicate with select monitoring systems to visually display
current infusion parameters. This option must be turned on by
the Biomedical Department.
Occlusion Warning is designed to alert the clinician of downstream
resistance. An audible warning (three beeps) and a visual
indication will occur 5 times at 5-second intervals before
alarming "Occlusion." This option must be turned on by the
Biomedical Department.
Piggyback Callback continues the primary infusion at a KVO rate
and alarms once the piggyback is complete.
PROFILE Mode incorporates a ramped delivery regimen based on
the patient's specific needs.
PROGRAM Mode lets the user program a maximum of nine
selected volumes of fluid.
q(x)° Schedule allows the programming of periodic IV infusions.
Schedule Next Run delays the start of an infusion for up to 24 hours.
Select MAX Pressure sets the occlusion pressure limit to the
maximum value of 750 mmHg.
Set PROFILE Parameters alters the ramping process.
Set Time and Volume allows the delivery rate to be calculated based
on time. (for example: 1000 ml to be infused over 8 hours)
Site Trend graphically displays the resistance to downstream fluid
flow. A Resistance Factor can be enabled by the Biomedical
Technician which will display a numerical value both on the
Run/Hold screen and when Site Trend graph is displayed.

Each of the above options are described more fully in this chapter.
The options are listed in alphabetical order.

Horizon Nxt® with MedScan

Modular Infusion System 5-1 6/00
950520 Rev F
 Check Battery Level:

Three states of the battery are possible: discharging, charging or

fully charged. Prior to unplugging the pump for transport purposes,
this feature makes it easy to determine the state of the battery.

1) Press MENU key

2) Press CURSOR key to select Alternate Menu
3) Press the MENU key
4) Press CURSOR key to select Check Battery Level
5) Press ENTER key

One of the three graphs below will be displayed:

Discharging:

The pump is unplugged or running

Check Battery Level
on battery.

DISCHARGING
EXIT

Charging:

The pump is not fully charged.

Check Battery Level

CHARGING

Fully Charged:

The pump is 95% or more charged.

Check Battery Level

FULLY CHARGED
EXIT

Press the ENTER key to return to the Hold or Run state.

Horizon Nxt® with MedScan

Modular Infusion System 5-2 6/00
950520 Rev F
 Hold Extender

The normal Hold Time is 3 minutes. Use this option to extend that
time to a maximum of 120 minutes.

1) Press HOLD key to add time in

Delay = 0 hr 23 min 40 sec
3 minute increments, or
2) Press CURSOR keys to select the Press HOLD to add 3 min
hours or minutes and use DATA Cursor to change
keys to change the value
3) Press ENTER key. Cancel

"Hold" is displayed on the LEDs. Press the RUN key to cancel the
pause and begin infusing. Press the ENTER key to cancel the
extended pause and return to the standard 3 minute hold. Press the
MENU key to cancel the pause and access the Menu system.

Micro Rate / Limit

This option is useful in environments where low rates are critical,

such as pediatrics or neonatal nurseries. The maximum rate limit
can be set as low as 5.0 ml/hr or as high as 99.9 ml/hr.

Note: If the pump is turned on with the Micro Rate Limit activated,
a Teddy Bear shows on the LCD screen for 4 seconds.

1) Press HOLD key

2) Press MENU key
3) Press CURSOR keys to select Alternate Menu
4) Press ENTER key
5) Press CURSOR keys to select "Micro Rate / Limit"
6) Press ENTER key

Horizon Nxt® with MedScan

Modular Infusion System 5-3 6/00
950520 Rev F
 1) Press right CURSOR key to select Set Micro Status: Off On
On
2) Press down CURSOR keys to select
Rate Limit Rate Limit = 59.9 ml/hr
3) Press DATA keys to set a rate limit
4) Press ENTER key Press ENTER when done

Note: If a rate exists or is entered that is higher than the Rate Limit
set, an audible signal occurs. The user will need to lower the
rate or exit this feature.

1) Press RUN key to start the MICRO

infusion.
Time Left = 7 hr 34 min
Total Infused = 24.1 ml
Occlusion Limit = 300 mmHg

Monitor Docking

Monitor Docking allows the Horizon Nxt® with MedScan to

communicate with select monitoring systems to display current
infusion parameters. Parameters displayed may vary depending on
which monitoring system is being used. Refer to Monitor Docking
Guide for operations and troubleshooting.

Set-up

Clamp the Serial Data Communication IR (Infrared) Module over

the Serial Data Communication fluid resistant window on the back
of the Horizon Nxt pump whose information you wish displayed.

1) Grasp the Serial Data Communication IR Module with index

finger on top and thumb on grooved surface on the bottom.
2) Hook the top of the unit onto the pump, and with thumb press the
grooved surface to clamp the bottom of the unit on the pump.

Occlusion Warning

Occlusion Warning is designed to alert the clinician of

downstream resistance. An audible warning (three beeps) and
visual a indication will occur 5 times at 5-second intervals before
alarming "Occlusion." This option must be turned on by the
Biomedical Department.

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 Piggyback Callback

Piggyback Callback, if activated, continues the primary infusion at

a KVO rate and causes the pump to alarm. This feature may be
accessed during the Run or Hold states.

1) Press MENU key

2) Press the CURSOR key to select Alternate Menu
3) Press ENTER key
4) Press CURSOR keys to select “Piggyback Callback”
5) Press ENTER key

1) Press CURSOR keys to select On When Piggyback Callback

2) Press ENTER key is ON, KVO will alarm as
soon as the Piggyback is
done.
Note: Piggyback Callback will Set Callback: Off On
return to the Off position when the
pump is turned off.

PROFILE Mode

The Profile Mode is described in Chapter 7 (Special Modes).

PROGRAM Mode

The Program Mode is described in Chapter 7 (Special Modes).

q(x)° Schedule

This option allows the programming of periodic antibiotics,

chemotherapy or other IV infusions. For example, antibiotics are
written to be infused "q 6° " (every 6 hours). It is important to have
a maintenance IV infusing. This option can only be enabled by
Biomedical personnel.

Note: A cassette must be loaded in the pump to program this

feature. The piggyback option is not available while using
this feature. The q(x)° option cannot be used while in DOSE,
PROFILE or PROGRAM Modes.

1) Press HOLD key

2) Press MENU key
3) Press CURSOR keys to select q(x)° Schedule
4) Press ENTER key
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 1) Press right CURSOR keys to select This feature allows
OK for periods of no
2) Press ENTER key infusion. Ensure IV
patency prior to start

Cancel OK

To Enter Data:

1) Press CURSOR keys to select "q(x) Dose q(x) 01 hr 00 min

hrs and min"
2) Press the DATA keys to set the
time interval between infusion.
(For example: q 6 hrs 00 min)
# Doses = 4
Dose Rate = 200.0 ml/hr
Dose Vol = 100 ml
Press ENTER when done

Note: The time interval can be 1 to 24 hours. There must be at least

15 minutes between each run.

1) Press down CURSOR key to select "# of Doses"

2) Press DATA keys to set the total number of doses to be infused.

Note: The total number of doses may not exceed 40.

1) Press down CURSOR key to select "Dose Rate"

2) Press the DATA keys to set the infusion rate in ml/hr.

1) Press CURSOR keys to select "Dose Vol"

2) Press the DATA keys to set the volume of each dose (for example:
4 doses, each 50 ml)

Note: The Dose Volume of each dose has to be greater than 1 ml

but not more than 2000 ml.

3) Press the ENTER key

To change the time:

1) Press up CURSOR key to select Present Time is

"Present Time is" 09:37a
2) Press DATA keys to set the correct Start dose at
time 10:35a

VALIDATE

Note: The time is displayed in military time. Use 00:00 to represent

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 midnight and 12:00 to represent noon. Verify that the Time
is correct.

1) Press CURSOR to select "Start Dose at"

2) Press DATA keys to set the time the infusion is to begin
3) Press the CURSOR keys to select "Validate"
4) Press ENTER key

Note: "q(x) Schedule Overlap"

message appears when doses
entered are not at least 15 minutes q(x) Schedule Overlap
apart. When this occurs the q(x)° Press HOLD to Silence Alarm
feature must be exited to cancel the
present infusion regimen.

"Wait Is" shows the amount of time

q(x) Start 10:35a DATA
until delivery starts
Wait Is 0 h 49 m
3 Doses left
Total Infused = 2.2 ml

Note: After pressing Enter, the pump goes into a waiting period.
"SCHd dLY" shows on the LED’s. No fluid is infusing
during this period.

1) Press ENTER key for the data screen

2) Follow the steps above to change the data, if necessary
3) Press ENTER key

At the q(x)° Start time, the pump will begin the infusion. During the
infusion "SCHd run" shows on the LED’s. The number of doses
remaining is shown on the LCD. After the infusion is complete, the
pump will automatically return to the waiting period. The pump will
continue to "infuse and wait" for the total number of doses entered.

q(x) Delivery DATA

Time Left = 0 hr 29 min
Total Infused = 2.7 ml
Occlusion Limit = 300 mmHg
3 Doses left

To Exit:
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 Note: The pump must be in the Hold state.

1) Press MENU key

2) Press CURSOR keys to select "Exit q(x)° Schedule
3) Press ENTER key

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 Schedule Next Run

This feature lets the user delay an infusion from Standard, DOSE,
PROFILE or PROGRAM Mode for up to 24 hours.

Note: The rate and volume information must be entered on either

the Primary or Piggyback channel and a set must be in the
pump before entering this feature.

1) Press MENU key

2) Press CURSOR keys to select Schedule Next Run
3) Press ENTER key

To Change the Time:

1) Press CURSOR key to select Schedule Next RUN

“Time is”, if necessary Time is 15:15p
2) Press DATA keys to set the Delay 2 hr 00 min
Start at 17:15p
correct time (in military time)
VALIDATE 01 H 00 M DELAY

To Change the Delay:

Note: The time is displayed in military time. Use 00:00 to represent

midnight and 12:00 to represent noon.

Either:

Press CURSOR keys to select “hr” or “min”

Press DATA keys to set the hours and minutes

or

Press CURSOR keys to select “Start at”

Press DATA keys to change the time

1) Press CURSOR keys to select “Validate”

2) Press ENTER key

The information is displayed on the Information Screen, “dLY” is

shown, and the yellow Hold LED will blink. Press the HOLD key to
cancel Schedule Next Run.

Note: To prevent tampering of the Schedule, press the Panel Lock

Out Switch on the rear of the pump.

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 Select MAX Pressure

The Horizon Nxt® with MedScan can be used for epidural

administration of anesthetic and analgesic drugs. Use this feature
when the maximum pressure of 750 mmHg is required for infusion.

Caution: Whenever the pump is being used for epidural infusions,

the pump’s secondary infusion features should not be
used.

For epidural administration of anesthetic drugs, use indwelling

catheters specifically indicated for short-term (96 hours or less)
anesthetic epidural drug delivery.

For epidural administration of analgesic drugs, use indwelling

catheters specifically indicated for either short-term or long-term
analgesic epidural drug delivery.

When the Horizon Nxt with MedScan is being used for epidural
infusions, the source container and administration set should be
clearly differentiated from source containers and administration sets
used for other routes of infusion.

Caution: To prevent inadvertent infusion of drugs not indicated for

epidural administration, use only Horizon microbore
administration sets without injection sites.

Following an occlusion alarm, a small amount of fluid may be

delivered. Use of a microbore set assures this is less than 0.1 mL.

The administration of drugs is restricted to those anesthetic and

analgesic drugs labeled for continuous epidural administration.

Warning: Serious injury to the patient may result from epidural

administration of drugs other than those specifically
labeled for epidural use.

Caution: The higher the pressure limit, the less sensitive the pump
is to changes in fluid resistance which may be caused by
positional IV’s or infiltrations. High pressure limits can
increase the severity of an infiltration without an alarm
condition.

1) Press HOLD key

2) Press MENU key.
3) Press CURSOR keys to select “Select MAX Pressure”
4) Press ENTER key

The occlusion pressure is 750 mmHg. To change the occlusion

pressure from 750 mmHg, turn the pump off and then on again, or
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 See “Occlusion Limit” to change the value.

Set PROFILE Parameters

Set PROFILE Parameters is described in Chapter 7 (Special Modes).

Set Time and Volume

Use this feature when an infusion rate is defined by time and

volume. The pump calculates the delivery rate.

1) Press HOLD key

2) Press MENU key
3) Press CURSOR keys to select “Set Time and Volume”
4) Press ENTER key

1) Press CURSOR keys to select “hr”

or “min”
2) Press DATA keys to enter the
Set Time and Volume
correct hours and minutes Rate = 125.00 ml/hr
3) Press CURSOR keys to select “ml” Time = 8 hr 00 min
4) Press DATA keys to enter the Volume = 1000 ml
volume VALIDATE
5) Press CURSOR keys to select
“VALIDATE”
6) Press ENTER key.
7) Press the RUN key to start the infusion.

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 Site Trend

Site Trend graphically displays the resistance to downstream fluid

flow for three intervals of time MAX, MED and MIN.

1) Press MENU key

2) Press the CURSOR key to select
MAX Site Trend Exit
Alternate Menu
3) Press ENTER key
4) Press CURSOR keys to select Site
Trend Now
5) Press ENTER key

Note: Data is shown from right to left. The word "Now" reinforces
the most current data is represented on the right side of the
graph. The arrow’s position, whether pointing upward or
downward, indicates either an increase or a decrease in the
downstream fluid resistance.

To Change Graphical Resolution:

1) Press up and down CURSOR key to change from MAX, MED or

MIN resolution

Note: MAX is the default setting. MIN displays more data points
compressed along the horizontal axis for a representation of a long-
term trend. MAX displays less data points in the same area for a
short-term trend.

Resistance Factor (RF):

Note: This feature needs to be activated by the Biomedical

Technician.

The Resistance Factor is a numeric value displayed and updated

during an infusion. "RF =" appears on either the Hold or Run Screen
when activated. The numerical value of RF appears after the words
"Site Trend" when the graph is displayed. Increasing RF values may
alert the clinician to a possible occlusion state due to kinks, clogged
filters, viscous fluids or infiltrations.

To Exit:

1) Press right CURSOR key to select Exit

2) Press ENTER key to exit

Exit from Menu

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 This feature returns the pump to the state it was in before pressing
the Menu key.

1) Press the CURSOR keys to select Exit from menu

2) Press the ENTER key

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Chapter 6 DOSE Mode
DOSE Mode calculates the concentration, rate or dose information
necessary for use with many critical drug infusions.

Note: Medication names available are listed in Chapter 9, Table 1.

1) Press HOLD key

2) Press MENU key
3) Press CURSOR keys to select DOSE Mode
4) Press ENTER key

If a drug name was used the last time in DOSE Mode, the following screen
will appear on the LCD:

If the medication is correct:

DOPAMINE
1) Press the ENTER key in the ICU/CCU category
2) Go to Data Screen is the current drug.
ACCEPT CHANGE EXIT MODE
Cursor & Press ENTER
or

To change to a new medication:

1) Press the CURSOR key to select "Change"

2) Press ENTER key

or

To Exit DOSE Mode:

1) Press CURSOR key to select "Exit Mode"

2) Press ENTER key
Drug Menus:
DRUG LISTS
1) Press the CURSOR key to select a category
ICU/CCU Neo & Pedi
2) Press ENTER key Med Surg Oncology
Anesthesia Epidural
CLEAR DRUG DOSE

An alphabetical list of medications is

ICU/CCU DRUG LIST
shown.
AMINOPHYLLINE
1) Press CURSOR keys to select the BRETYLIUM
CISPLATIN
medication. DEXAMETHASONE
2) Press ENTER key

To clear the drug name:

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 1) Press CURSOR key to select "Clear Drug"
2) Press ENTER
3) Go to Data Screen

Note: Generic calculation can be used for drugs not appearing on the list.

Epidural Category:

1) Press CURSOR key to select "Epidural"

2) Press ENTER Pressure will be set to 750
mmHg, and Micro Rate will be
enabled.
Use sets labeled for Epidural
use only.

Concentration Screen:

A screen with 2 standard concentrations and a "wild card" line is shown

1) Press CURSOR keys to select a

DOPAMINE
concentration
2) Press ENTER key 400 mg in 500 ml
400 mg in 250 ml
0.0 mg in 0 ml
Press ENTER when done

Note: No data entry can be done here. The concentration can be changed
later (See Data Screen.)

Data Screen:

Body Weight:

1) Press CURSOR keys to select the Body

Body Weight = 70 kg
Weight value (if shown) Conc = 400.0 mg / 500 ml
2) Press DATA keys to change the value Dose = 5.0 mcg/kg/min
Rate = 26.3 ml/hr
VALIDATE DRUG SETUP

Calculated Parameter:

Concentration, Dose and Rate are interdependent on each other for their
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 numeric values. Specifying the amount of two parameters cause the third
parameter to be calculated.

For example: Specifying a weight of 70 kg, a concentration of 400 mg of

Dopamine in 500 ml of fluid at a dose of 5.0 mcg/kg/min
resulted in a calculated rate of 26.3 ml/hr.

Note: Either the Concentration (Conc), Dose or Rate parameter is

calculated. Rate is the parameter calculated unless another
parameter is chosen.

To Choose Another Parameter:

1) Press left CURSOR key

2) Press up and down CURSOR keys to select the parameter to be calculated
3) Press the right CURSOR key

Note: The parameter that was highlighted is now underlined. That

underlined parameter is the calculated parameter.

Enter Data:

1) Press DATA keys to change value

Body Weight = 70.0 kg
2) Press CURSOR key to select
Conc = 400.0 mg / 500 ml
3) “VALIDATE ” Dose = 5.00 mcg/kg/min
4) Press ENTER key Rate = 26.3 ml/hr
5) Press RUN key to start the infusion VALIDATE DRUG SETUP

Rate and Volume data is transferred to the displays. The name of the
medication and "DOSE" are shown on the Information Screen.

Change SETUP Parameters:

Critical medications require parameters for calculation of doses, for

example mcg/kg/min. Three categories of parameters are Dosage,
Concentration (Conc) and Body. Each of these can be independently
selected and changed. Match the dosage and concentration written by the
doctor.

1) Press HOLD key

2) Press MENU key
3) Press CURSOR keys to select DOSE Mode
4) Press right CURSOR key to select SETUP
5) Press ENTER key

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 1) Press the left or right CURSOR keys to DOSAGE CONC BODY
move to the appropriate parameter
2) Press the up or down CURSOR keys to mcg/kg/min mg kg
change to the correct parameters (mcg/ change move
kg/min to units/hr) Press ENTER when done
3) Press ENTER key

Titrate Rate:
The rate can be titrated while the pump is running. Press the DATA keys to
change the rate. The dose is recalculated and shown. The ENTER key or RUN
key must be pressed within four seconds to validate the change. Once made,
the pump infuses at the new rate.

Note: If the ENTER key or RUN key is not pressed within 4 seconds of
entering a new rate, a series of error beeps will occur and the rate
change will be cancelled. The pump will then display the message
"Rate change aborted", and will continue to infuse at the old rate.
An intermittent alarm will continue to sound to notify the user that a
rate change has been attempted and cancelled. Pressing any key will
silence the alarm.
Titrate Dose:

1) Press ENTER key

2) Press CURSOR keys to select the Dose value
3) Press DATA keys to change the values
4) Press CURSOR keys to select "VALIDATE"
5) Press ENTER key

Monitor the infusion as indicated by hospital policy. The pump will alarm
and go into the KVO state when the volume is infused. “KVO: DOSE
COMPLETE” is shown on the Information Screen.

1) Press the HOLD key

2) Press the DATA keys to put in a new volume
3) Press RUN key to start infusion

Exit DOSE Mode:

1) Press HOLD key

2) Press MENU key
3) Press CURSOR keys to select "Exit DOSE Mode"
4) Press ENTER key. The pump will return to the standard Hold state

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Chapter 7 SPECIAL MODES

PROFILE Mode
This mode lets the user deliver fluid in a ramped delivery pattern (ramp up,
plateau deliver, and ramp down) over a selected period of time.

If the pump was turned off while in the PROFILE Mode, the following
screen will appear:

1) Press CURSOR keys to select the PROFILE Operation

appropriate message was Interrupted
2) Press ENTER key
Resume current PROFILE
Restart PROFILE
Exit PROFILE Mode

The pump will return to PROFILE Hold

state.

Change PROFILE Parameters:

1) Press Menu key

2) Press Cursor keys to select Set PROFILE Parameters
3) Press Enter key

1) Press the Cursor keys to select Ramp Up,

Ramp Down or MAX Rate Ramp Up = 1 hr 0 min
2) Press Data keys to change the values Ramp Down = 1 hr 0 min
3) Press Cursor keys to select "VALIDATE Max Rate = 300 ml/hr
Parameters" VALIDATE Parmameters
4) Presss Enter key

Note: The minimum ramp time is 10 minutes; the maximum ramp time 120
minutes. The largest value for maximum rate is 400 ml/hr.

Data Entry:

1) Press MENU key

2) Press CURSOR keys to select "PROFILE Mode"
3) Press ENTER key

1) Press DATA keys to enter the Volume

2) Press CURSOR keys to select time Volume = 1000.0 ml
3) Press DATA keys to enter the Time Time = 8 hr 0 min
4) Press the CURSOR keys to select
"VALIDATE PROFILE"
VALIDATE PROFILE
5) Press the ENTER key

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 “Profile Ready” will appear at top of Information Screen.

Press RUN key to start. “PROFILE RAMP UP” will be displayed on the
Information Screen.

1) Press ENTER key for a graph RAMP TEXT

2) Press ENTER key for the text UP

VOLUME DELIV TIME LEFT

0.2 ml 9 H 58 M

Review/Change PROFILE Data:

Note: Volume cannot be changed after an infusion is started.

1) Press MENU key

2) Press CURSOR keys to select “Review/Change PROFILE”
3) Press ENTER key

1) Press CURSOR keys to select Time

2) Press DATA keys to change the time
3) Press the CURSOR keys to select "VALIDATE PROFILE"
4) Press the ENTER key
5) Press RUN to start

Restart PROFILE:

1) Press HOLD key

2) Press MENU key
3) Press CURSOR keys to select "Restart PROFILE"
4) Press ENTER key

1) Press CURSOR keys to select "YES"

2) Press ENTER key The "Restart PROFILE"
option will cancel the
3) Press RUN key present run. Is this OK?
Yes No
Immediate Ramp Down: Cursor & Press Enter

1) Press the MENU key

2) Press the CURSOR keys to select "Immediate Ramp Down"
3) Press the ENTER key

“Immediate Ramp Down” shows on the Information Screen.

Note: The Immediate Ramp Down time is 30 minutes or less.

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 Upon completion of Immediate Ramp Down, the pump enters the KVO
state. To silence the alarm, press the HOLD key.

Exit PROFILE Mode:

1) Press HOLD key

2) Press MENU key
3) Press CURSOR keys to select "Exit PROFILE Mode"
4) Press ENTER key

1) Press CURSOR keys to select"YES" The "Exit PROFILE mode"

2) Press ENTER key option will cancel the
present run. Is this OK?
Yes No
Cursor & Press Enter

The pump will return to the standard Hold state.

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PROGRAM Mode
This mode lets the user program up to nine different rates and volumes. The
pump will deliver the fluid sequentially. Fluid delivery can be customized
for each patient.

If the pump was turned off while in the PROGRAM Mode, this screen will
appear:

1) Press CURSOR keys to select the PROGRAM Operation

appropriate message was Interrupted
2) Press ENTER key
Resume current PROGRAM
Restart PROGRAM
Exit PROGRAM Mode

The pump will return to Program Hold state.

1) Press MENU key

2) Press CURSOR keys to select "PROGRAM Mode"
3) Press ENTER key

Data Entry:

1) Press CURSOR keys to select Rate or Pd. Rate Volume

Volume
1 0.0 0.0 ZERO
2) Press DATA keys to change the values
2 0.0 0.0
3) Press CURSOR keys to select the next 3 0.0 0.0
period
VALIDATE TOTAL = 0.0 ml
4) Repeat until all information is entered
(up to 9 periods)

Note: VALIDATE cannot be selected when 0.0 data is present in the

middle of a Program, for example:

NOT ALLOWED Pd. Rate Volume

1 50.0 35.0
2 0.0 0.0
3 30.0 150.0 ZERO
VALIDATE TOTAL = 0.0 ml

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 NOT ALLOWED Pd. Rate Volume
1 50.0 35.0
2 35.0 0.0
3 30.0 500.0 ZERO
VALIDATE TOTAL = 0.0 ml

ALLOWED
Pd. Rate Volume
1 50.0 35.0
2 100.0 500.0
3 0.0 0.0 ZERO
VALIDATE TOTAL = 0.0 ml

1) Press RUN key to start the infusion

2) Period 1 is infusing as displayed
3) Press ENTER key to display a graph
4) Press ENTER key to return to the text display

Each period is represented by a vertical bar which fills as the fluid is infused.
The height of the bar represents the rate of infusion in that particular period.
The period presently being infused is displayed in the upper left corner. If
the vertical bar appears to be missing, the rate in that period is much less
compared to the other periods.

Review/Change PROGRAM:

Note: A Program cannot be changed after it has been started.

1) Press MENU key

2) Press CURSOR keys to select “Review/Change PROGRAM”
3) Press ENTER key

1) Press CURSOR keys to select rate

2) Press DATA keys to change the rate values
3) Press ENTER key

Note: Only rate can be changed after an infusion has started

4) Press CURSOR keys to select “Validate”

5) Press ENTER key

Restart PROGRAM:

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 1) Press HOLD key
2) Press the MENU key
3) Press CURSOR keys to select “Restart PROGRAM”
4) Press ENTER key

1) Press CURSOR keys to select “Yes” The "Restart PROGRAM"

2) Press ENTER key option will cancel the
3) Press RUN key present run. Is this OK?
Yes No
Cursor & Press ENTER

Skip PROGRAM Periods:

1) Press HOLD key

2) Press MENU key
3) Press CURSOR keys to select "Skip PROGRAM Periods"
4) Press ENTER key

1) Press the DATA keys for VTBD to

remove the volume
2) The bar on the graph moves to show the
volume skipped Skip 0.0 ml / 12.0 left
3) Press ENTER key Press ENTER when done
4) Press RUN key

Upon completion of the program, the pump enters the KVO state. Press the
HOLD key

Exit PROGRAM Mode:

1) Press HOLD key

2) Press MENU key
3) Press CURSOR keys to select "Exit PROGRAM Mode”
4) Press ENTER key

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Chapter 8 MAINTENANCE

Cleaning
Clean the pump with a soft, lint-free cloth or swab dampened with soap and
water, a general nonstaining chemical disinfectant, or alcohol (90%
concentration or less.). DO NOT use acetone solutions containing
glutaraldehyde, ammonium chlorides or abrasive cleansers on the
pump. If you feel it necessary, Betadine or Iodine solutions may be used,
but they will stain the device.

As a general recommendation for cleaning and disinfection of this device,

use a lintfree cloth dampened with a 0.5% Sodium Hypochlorite solution
(one part bleach with nine parts water). The solution is most effective when
prepared weekly and allowed to remain on the device for approximately 10
minutes prior to wiping off. Please be sure NOT to use abrasive cleaning
tools or pressurized spraying devices for these may damage the pressure
transducer or cause fluid intrusion.

Warning: To avoid mechanical or electronic damage, do not steam

autoclave or immerse the pump in any fluids or cleaning
solutions.

Caution: To avoid electrical shock, turn off the pump and disconnect it
from the electrical outlet before cleaning.

Sterilization of the pump using ethylene oxide (EtO) gas is not

recommended.

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Alarm Procedures

An alarm notifies the user that the condition indicated on the Information
Display has occurred and that corrective action must be taken to continue
the infusion process.

When an alarm condition occurs, the following steps are recommended:

1) Press the HOLD key.

2) Press the MENU key to display on the Information Display the correction
messages contained in the “Correction” column of the Troubleshooting
Guide.
3) Correct the cause of the alarm.
4) Press the RUN key to restart the infusion.
5) Monitor the process according to hospital policy.

There are 3 types of alarms:

1) Operation alarms - Press the MENU key to see the Help Screen which
contains the guidelines in the “Correction” column of the Alarm
Troubleshooting Guide. Clear the alarm by pressing the HOLD key.

2) System alarm - Press the HOLD key, and press the RUN key to restart the
infusion.

3) Repair Instrument alarm - Press the HOLD key and turn the pump off and
then on again (Similiar to rebooting a personal computer.). If the alarm
recurs, return the pump to a Biomedical Professionial for service.

For assistance, call (800) 627-PUMP.

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Alarm Troubleshooting Guide

MESSAGE LED MESSAGES CORRECTION

Air-in-Line Air Air in downstream tubing
Tubing improperly inserted in Air-
in-Line Detector.
Battery Very Low Use AC Plug into AC power NOW to contin-
ue operation
Container Empty SOLU Check for air in set
IV container empty
Check upstream clamp
Check cassette installation
Door Open door The door must be shut to deliver flu-
id
Downstream Occlusion OCCL Clamp closed or filter blocked
Tubing kinked
IV positional or infiltrated
Catheter or vein too small
Check occlusion limit
Hold Time Exceeded HOLd Press Hold key, three minute time
period is restarted
KVO flashing LED’s Pump is operating in Keep Vein
Open state
Infusion is complete
Set volume to be delivered
Restart or turn off the pump
Low Battery PLUG IN Battery too low; plug in AC

System Error SYS Err Turn the pump off and return to Bio-
medical Professional for service
See Help SEE HELP CLOSE ROLLER CLAMP, then
open door. Press LOAD and reload
tubing.
Cassette not in place
Set Piggyback Rate Set a Piggyback rate

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 Set Piggyback Volume Set a Piggyback volume

Set Primary Rate Set a Primary rate

Set Primary Volume Set a Primary volume

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950520 Rev F
Cautions
Before using the pump in a clinical setting, the user should become
thoroughly familiar with the proper use of the device as outlined in this
Operation Manual.

The Horizon Nxt® Infusion Pump is not intended to substitute for regular
patient observation and evaluation.

Do not attempt to infuse two fluids simultaneously using the Horizon Nxt
Infusion Pump.

Each time the pump is turned on, verify that the alarm sounds during the
momentary test sequence. If the alarm continues to sound or an alarm
message is displayed, refer to Alarm Procedures.

Unrestricted fluid flow may occur if the I.V. set is not properly installed.

Whenever the pump is being used for epidural infusion, the pumps’
secondary infusion features should not be used.

To prevent inadvertent infusion of drugs which are not indicated for

epidural use, only Horizon microbore administration sets without injection
sites are required for epidural administration of drugs. Following an
occlusion alarm a small amount of fluid may be delivered. Use of a
microbore set assures this is less than 0.1 mL.

Serious injury to the patient may result from epidural administration of

drugs other than those specifically labeled for epidural use.

It is not recommended to stack more than five pumps on one I.V. pole.

Use only with B. Braun Medical Horizon® I.V. Sets

Perform testing and/or preventive maintenance as defined in the product

Service Manual. It is necessary to perform all testing and preventive
maintenance as defined in the product Service Manual, or the reliability and
proper functionality of the unit cannot be assured.

The higher the maximum pressure limit, the less sensitive the pump is to
changes in fluid resistance which may be caused by positional I.V.'s or
infiltrations. High pressure limits can increase the severity of an infiltration
without causing an alarm condition.

Unless the pump is plugged into a hospital-grade electrical outlet the

reliability of the grounding cannot be assured.

A possible explosion hazard exists if the pump is used in the presence of

flammable anesthetics.

To avoid electrical shock, turn off the pump and disconnect it from the
Horizon Nxt®
Modular Infusion System 8- 5 6/00
950520 Rev F
 electrical outlet before cleaning.

Do not use the pump in the presence of strong electromagnetic fields. The
field may permanently damage the pump. For further information, consult
the manufacturer of the equipment in question.

To avoid mechanical or electronic damage, do not steam autoclave or

immerse the pump in any fluids or cleaning solutions.

A possible electrical shock hazard exists if the case of the pump is opened
or removed. Refer all servicing to authorized service personnel.

Do not use visibly damaged pumps or pumps with bent, damaged or missing
components.

Pumps should be tested for proper performance semiannually.

Federal (U.S.A.) law restricts this device to sale by or on the order of a

physician.

Horizon Nxt®
Modular Infusion System 8-6 6/00
950520 Rev F
Service and Performance Information

If the pump fails to respond to the operating or troubleshooting procedures

listed in this manual and the cause cannot be determined, discontinue using
the pump and forward it to an authorized B.Braun Medical Service Center.

Should it be necessary to return the pump for repair, contact Customer

Service at the phone number below for a Returned Goods Authorization
(RGA) number, then carefully pack the pump (preferably in the original
packing), and ship it prepaid to the address below. B. Braun Medical cannot
assume any responsibility for loss or damage to returned instruments while
they are in transit.

Service and product performance information, operation training, service

training, and service manuals may be obtained from the manufacturer by
contacting:

B. Braun Medical Inc.

1601 Wallace Drive, Suite 150
Carrollton, Texas 75006 USA
Attn: Manager of Service
Or call: (800) 627-PUMP

Product complaints may be sent to the Manager of Quality Assurance at the

above address. With each complaint, please include:

1) The pump's serial number

2) Software Revision
3) A description of the difficulty experienced
4) The pressure limit setting
5) The rate setting
6) The initial volume(s) to be infused
7) The type of fluid(s)
8) The amount of time between the start of the infusion and the time the
difficulty was noticed
9) The message displayed at the time the difficulty occurred
10) The catalog and lot number of the set(s) in use
11) Any other information which might aid in the investigation of the
complaint

Horizon Nxt®
Modular Infusion System 8- 7 6/00
950520 Rev F
Specifications

Mechanism: Volumetric (Non Drop-Counting), Positive

Pressure Displacement Reservoir
Dimensions: Width 12.4” (31.5 cm)
Height 4.8 (12.2 cm)
Depth 12.2” (31.5 cm)

Weight: Approximately 11.9 lb. (5.4 Kg)

Power Requirements:
Grounding Resistance
Leakage Current:
Plug:
Pole Size Range:
Battery:
Rate Range:
Volume to be Infused Range:
Occlusion Pressure
Keep Open Rate:
Volume Delivered Accuracy:
Fluid Types:
90-132 VAC, 30 Watts, 47/63 Hz excluding
accessories (domestic), 180- 264 VAC, 30
Watts, 47/63 Hz excluding accessories (Inter-
national)
Meets UL Standard 544
Meets or exceeds UL Standard 544, Section
27.2, and ANSI/AAMI Safe Current Limits
(July 9, 1985)
Hospital Grade (3 pin)
0.75" to 1.25"
12 Volt sealed lead-acid battery for ambulatory
use. Run time is dependent on the state of bat-
tery charge and the rate of fluid delivery.
Standard: (Primary and Piggyback) 0.1 to
999.9 mL/hr
Micro: (Primary and Piggyback) 0.1 to 99.9
mL/hr
0.1 to 9999.9 mL
75, 100, 200, 300, 400, 500 and 750 mmHg
Standard mode default is 300 mmHg.
3 mL/hr for prescribed delivery rates of 3 to
999.9 mL/hr, or the continuation of the pre-
scribed delivery rate for 0.1 to 2.9 mL/hr set-
tings.
+/- 5%
All standard I.V. fluids

Horizon Nxt®
Modular Infusion System 8-8 6/00
950520 Rev F
Alarms: Air-In-Line, Container Empty, Door Open,
Downstream Occlusion, Hold Time Exceeded,
Low Battery, Low Flow from Container, Close
Roller Clamp, Sys Err, Upstream Occlusion
Air-in-Line Alarm: 0.09 cc
Hold Time Exceeded Alarm: Activated after three minutes on hold without
user interaction (deactivated if the door of the
pump is open)
Memory: Permanent data retention after the pump is
turned off, unless the battery is depleted or dis-
connected, or unless the Data Retention De-
faults have been otherwise selected in the
Biomed Options.

Horizon Nxt®
Modular Infusion System 8- 9 6/00
950520 Rev F
Chapter 9 Table 1
Drug List
Name Concentration Dosage Units

Alfentanil 3.5 mg in 7 ml mcg/kg/min

500 mcg in 1 ml
0 mg in 0 ml
Aminocaproic Acid 15 g in 500 ml g/hr
15 g in 250 ml
0 g in 0 ml
Aminophy (mg/hr) 500 mg in 500 ml mg/hr
500 mg in 250 ml
0 mg in 0 ml
Aminophy (mg/kg/hr) 500 mg in 500 ml mg/kg/hr
500 mg in 250 ml
0 mg in 0 ml
Amiodarone 150 mg in 100 ml mg/min
900 mg in 500 ml
0 mg in 0 ml
Amrinone 500 mg in 500 ml mcg/kg/min
500 mg in 250 ml
0 mg in 0 ml
Bretylium 2 g in 500 ml mg/min
4 g in 500 ml
0 g in 0 ml
Cisplatin 0 mg in 1000 ml mg/m2/hr
0 mg in 500 ml
0 mg in 250 ml
Cyclophosphamide 0 mg in 0 ml mg/kg/min
0 mg in 0 ml
0 gm in 0 ml
Dexamethasone 0 mg in 0 ml mg/kg/hr
0 mg in 0 ml
0 mg in 0 ml
Diltiazem 125 mg in 125 ml mg/hr
250 mg in 250 ml
0 mg in 0 ml

Horizon Nxt®
Modular Infusion System 9-1 6/00
950520 RevF
 Name Concentration Dosage Units

Dobutamine 500 mg in 500 ml mcg/kg/min

500 mg in 250 ml
0 mg in 0 ml
Dopamine 400 mg in 500 ml mcg/kg/min
400 mg in 250 ml
0 mg in 0 ml
Doxorubicin 0 mg in 0 ml mg/m™/min
0 mg in 0 ml
0 mg in 0 ml
Epinephrine 1:1000 3 mg in 250 ml mcg/min
6 mg in 250 ml
0 mg in 0 ml
Esmolol 5 g in 500 ml mcg/kg/min
5 g in 250 ml
0 mg in 0 ml
Etoposide (VP-16) 0 mg in 0 ml mg/m2/hr
0 mg in 0 ml
0 mg in 0 ml
Fentan (mcg/kg/min) 50 mcg in 1 ml mcg/kg/min
2.5 mg in 50 ml
2.5 mg in 50 ml
Fentan (mcg/kg/hr) 50 mcg in 1 ml mcg/kg/hr
2.5 mg in 50 ml
2.5 mg in 50 ml
Fluorouracil (5-FU) 0 mg in 0 ml mg/kg/hr
0 mg in 0 ml
0 mg in 0 ml
Furosemide 100 mg in 50 ml mg/min
0 mg in 0 ml
0 mg in 0 ml
Heparin (units/hr) 20,000 units in 500 ml units/hr
25,000 units in 250 ml
0 units in 0 ml
Heparin (units/kg/hr) 20,000 units in 500 ml units/kg/hr
25,000 units in 250 ml
0 units in 0 ml

Horizon Nxt®
Modular Infusion System 9-2 6/00
950520 RevF
 Name Concentration Dosage Units

Hydromorphone 50 mg in 5 ml mg/hr
500 mg in 50 ml
0 mg in 0 ml
Insulin (Regular) 0 units in 0 ml units/hr
0 units in 0 ml
0 units in 0 ml
Isoproterenol 3 mg in 250 ml mcg/min
6 mg in 250 ml
0 mg in 0 ml
KCL 20 mEq in 50 ml mEq/hr
40 mEq in 100 ml
0 mEq in 0 ml
Labetalol 200 mg in 200 ml mg/min
200 mg in 250 ml
0 mg in 0 ml
Lidocaine 2 gm in 500 ml mg/min
4 gm in 500 ml
0 gm in 0 ml
Magnesium Sulfate 5000 mg in 250 ml g/hr
5000 mg in 500 ml
0 mg in 0 ml
Methotrexate 0 mg in 0 ml mg/kg/min
0 mg in 0 ml
0 mg in 0 ml
Midazolam 25 mg in 50 ml mg/hr
50 mg in 50 ml
0 mg in 0 ml
Milrinone 10 mg in 10 ml mcg/kg/min
20 mg in 100 ml
0 mg in 0 ml
Morphine 10 mg in 50 ml mg/hr
10 mg in 1 ml
0 mg in 0 ml
NTG (mcg/min) 50 mg in 250 ml mcg/min
100 mg in 250 ml
0 mg in 0 ml

Horizon Nxt®
Modular Infusion System 9-3 6/00
950520 RevF
 Name Concentration Dosage Units

NTG (mcg/kg/min) 50 mg in 250 ml mcg/kg/min

100 mg in 250 ml
0 mg in 0 ml
Nitroprusside 200 mg in 500 mg mcg/kg/min
50 mg in 250 ml
0 mg in 0 ml
Norepinephrine 8 mg in 500 ml mcg/min
8 mg in 250 ml
0 mg in 0 ml
Ondansetron 32 mg in 50 ml mg/kg/hr
0 mg in 0 ml
0 mg in 0 ml
Oxytocin 10 units in 1000 ml millU/min
10 units in 500 ml
0 units in 0 ml
Phenylephrine 30 mg in 500 ml mcg/min
50 mg in 500 ml
0 mg in 0 ml
Procainamide 2 g in 500 ml mg/min
4 g in 500 ml
0 g in 0 ml
Propofol (mg/kg/min) 200 mg in 20 ml mg/kg/min
600 mg in 60 ml
0 mg in 0 ml
Propofol (mcg/kg/min) 200 mg in 20 ml mcg/kg/min
600 mg in 60 ml
0 mg in 0 ml
Propranolol 15 mg in 500 ml mg/hr
15 mg in 250 ml
0 mg in 0 ml
Ranitidine 50 mg in 100 ml mg/hr
150 mg in 1000 ml
0 mg in 0 ml
Sufentanil 250 mcg in 5 ml mcg/kg/hr
50 mcg in 1 ml
0 mcg in 0 ml

Horizon Nxt®
Modular Infusion System 9-4 6/00
950520 RevF
 Name Concentration Dosage Units

Urokinase 750,000 units in 500 ml units/kg/hr

300,000 units in 200 ml
0 units in 0 ml
Vasopressin 150 units in 250 ml milli U/min
200 units in 250 ml
0 units in 0 ml
Vercuronium 5 mg in 5 ml mcg/kg/min
10 mg in 5 ml
0 mg in 0 ml

Horizon Nxt®
Modular Infusion System 9-5 6/00
950520 RevF
 Name Concentration Dosage Units

Caution: Federal Law restricts this device to

sale by or on the order of a physician.

B.Braun Medical Inc.

Carrollton, TX USA 75006

Horizon Nxt®
Modular Infusion System 9-6 6/00
950520 RevF
INDEX

A
Air-In-Line, 2-3
Alarm Procedure, 8-2
Alarm Volume, 4-1, 4-2
Alternate Menu, 4-1

B
Battery Operation, 2-4
Blood Infusion, 1-3
Body Surface Area (BSA), 4-1, 4-4

C
Calculate BSA, 4-1, 4-4
Cassette Alignment Pins, 2-3
Cassette Removal, 3-1
Change Alarm Volume, 4-1, 4-2
Changing the Rate, 3-3
Check Battery Level, 5-1, 5-2
Clear Total Infused, 4-1, 4-2

D
Daisy Chaining, 2-4
Data Keys, 2-2, 2-4
Dose Mode, 2-1, 4-1, 6-1
Body Weight, 6-2
Calculated Parameter, 6-2
Change Medication, 6-1
Change SETUP Parameters, 6-3
Clear Medication, 6-1
Concentration Screen, 6-2
Data Screen, 6-2
Drug Menus, 6-1
Enter Data, 6-3
Epidural, 6-2
Exit Dose Mode, 6-4
Titrate Dose, 6-4
Titrate Rate, 6-4

E
Enter Key, 2-2, 2-4
Epidural Administration, 1-2, 5-9, 6-2

F
Free Flow Protection Clip, 2-3

Horizon Nxt®
Modular Infusion System Index - 1 6/00
950520 Rev F
H
Hold Extender, 5-1, 5-3

I
Illustrations
Front View, 2-2
Rear View, 2-3
Inside the Door, 2-3

K
KVO, 2-1

L
LCD Contrast, 4-1, 4-4

M
Menu Key, 2-2, 2-4
Micro Rate / Limit, 5-1, 5-3
Monitor Docking, 5-4

O
Occlusion limit, 4-1, 4-3
Occlusion Warning Notification, 5-1, 5-4

P
Panel Lockout Switch, 2-3
Piggyback Callback, 3-3, 5-1, 5-5
Piggyback Fluids, 3-2
Piggyback Indicator Key, 2-2
Power Key, 2-2, 2-4
Profile Mode, 5-1, 7-1
Change Profile Parameters, 7-1
Data Entry, 7-1
Exit PROFILE Mode, 7-3
Immediate Ramp Down, 7-2
Restart PROFILE, 7-2
Review/Change PROFILE Data, 7-2
Set Profile Parameters, 7-1
Program Mode 5-1, 7-4
Data Entry, 7-4
Exit PROGRAM Mode, 7-6
Restart PROGRAM, 7-6
Review/Change PROGRAM, 7-5
Skip PROGRAM Periods, 7-6

Horizon Nxt®
Modular Infusion System Index - 2 6/00
950520 Rev F
Q
q(x)° Schedule, 5-1, 5-5

S
Schedule Next Run, 5-1, 5-9
Select MAX Pressure, 5-1, 5-10
Set Time & Volume, 5-1, 5-11
Site Trend, 5-1, 5-12
Standard Mode, 2-1
For Primary Fluids, 3-2
For Piggyback Fluids, 3-2
Sympathetic flow, 3-3

T
Titration, 3-3, 6-4

Horizon Nxt®
Modular Infusion System Index - 3 6/00
950520 Rev F